von Willebrand E, Sandberg M, Salmela K, Isoniemi H, Häyry P
Transplantation Laboratory, Helsinki University of Helsinki, Finland.
Transpl Int. 1994;7 Suppl 1:S308-10. doi: 10.1111/j.1432-2277.1994.tb01376.x.
We studied the relationship between ICAM-1 and class II expression on graft tubular cells and the relationship with graft inflammation in 50 kidney transplants monitored with serial aspiration biopsies after transplantation. Of the 50 grafts, 26 had an acute rejection 17 +/- 10 days after transplantation, 5 also had acute vascular rejection (AVR) and 24 had no rejection. The initial post-transplant ICAM-1 and class II expression was low in all grafts. All 21 grafts with acute cellular rejection (ACR) displayed ICAM-1 induction, with a peak at the beginning of acute blastogenic rejection and declining over 20 days to prerejection levels. Class II expression reached a peak later and also declined later to prerejection levels. In the grafts with irreversible AVR both ICAM-1 and class II expression remained elevated. The 24 grafts with no rejection displayed no ICAM-1 or class II induction on tubular cells during the follow-up. The differences between ICAM-1 and classs II expression in biopsies with rejection and with no rejection were statistically significant. The results demonstrate that ICAM-1 was induced early during ACR on the graft tubular cells and that it disappeared rapidly in reversible rejections. The induction of class II antigens was slightly slower but quantitatively greater. In the irreversible rejections with a combination of ACR and AVR both ICAM-1 and class II expression remained elevated.
我们对50例肾移植受者进行了研究，在移植后通过系列穿刺活检监测移植物肾小管细胞上细胞间黏附分子-1（ICAM-1）和Ⅱ类分子的表达情况及其与移植物炎症的关系。50例移植物中，26例在移植后17±10天发生急性排斥反应，5例同时伴有急性血管排斥反应（AVR），24例未发生排斥反应。所有移植物移植后初期ICAM-1和Ⅱ类分子表达均较低。所有21例发生急性细胞排斥反应（ACR）的移植物均出现ICAM-1诱导表达，在急性增殖性排斥反应开始时达到峰值，2０天内逐渐下降至排斥反应前水平。Ⅱ类分子表达峰值出现较晚，下降也较晚至排斥反应前水平。在发生不可逆AVR的移植物中，ICAM-1和Ⅱ类分子表达均持续升高。24例未发生排斥反应的移植物在随访期间肾小管细胞未出现ICAM-1或Ⅱ类分子诱导表达。有排斥反应和无排斥反应的活检组织中ICAM-1和Ⅱ类分子表达差异具有统计学意义。结果表明，ACR时移植物肾小管细胞早期诱导表达ICAM-1，在可逆性排斥反应中其迅速消失。Ⅱ类抗原诱导表达稍慢但量上更多。在合并ACR和AVR的不可逆性排斥反应中，ICAM-1和Ⅱ类分子表达均持续升高。
